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KMID : 0605920030090010019
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Journal of Korean Association of Pediatric Surgeons
2003 Volume.9 No. 1 p.19 ~ p.23
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Necrotizing Enterocolitis in Term Infants
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Kim Dae-Yeon
Kim Seong-Chul
Kim Kyung-Mo
Kim Ai-Rhan
Kim Ki-Soo
Pi Soo-Young
Kim In-Koo
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Abstract
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Necrotizing Enterocolitis (NEC) is usually a disease of premature infants, but occasionally it affects the term neonate. Twenty-five infants with NEC were treated at Asan Medical Center between January 2000 and December 2002, and 13 of them were term infants. In each case, the diagnosis of NEC was established by a clinical illness fulfilling the Bell’s stage Ⅱ or Ⅲ NEC as modified by Walsh or by surgical findings. There were six males and seven females. The birth weight was from 1,960 to 3.700g. The age at diagnosis was from 1 to 40 days. Four patients had congenital heart disease: one of who had hypothyroidism and cleft palate. Abdominal distension was present in all, and bloody stools in four. One patient had history of hypoglycemia, three had Rota viral infection. Eight patients had leucopoenia (<5.0×10^(9)/L), seven had thrombocytopenia ((100×10^(9)/L), and three severe thrombocytopenia (<50×10^(9)/L). Laparotomy was required in 10 of the 13 patients. Indications for operation in the acute phase were failure to respond to aggressive medical therapy in five, and perforation in three patients. There were two late phase operations for intestinal stricture and fistula. There were no operative complications. Ten of thirteen patients survived (76.9%). Two patients died of septic complication. There was a delayed death due to heart failure. There was a significant difference in survival according to platelet count (50×10^(9)/L) (p
(J Kor Assoc Pediatr Surg 9(1):19~23), 2003.
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KEYWORD
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Necrotizing enterocolitis, Term infant
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